This paper examines the rise of psychiatric thinking and practice and the “disciplinization” of the mind sciences in the Levant. Focusing on the mashreq, the paper situates the birth of psychiatry not in the usual framework of modernization, proselytism or merely the civilizing mission of the late nineteenth century but in a continuous power struggle between diverse local and global actors (including the British, French, Russian, and Ottoman imperial powers as well as different clerical and secular groups). This power struggle amounted to a politics of monopolizing knowledge through the creation and development of “zones of influence” whenever the opportunity arose; from the humanitarian interventions of the 1860s in Mount Lebanon to the Cold War a century later. The foreign powers were not the only self-interested actors in the story; so were the natives who benefited from the productive competition over education and health services. The French historian Jean-Pierre Filiu has called the paradoxical combination of colonial exploitation and cultural proliferation évènement-Janus. In many ways the birth of psychiatry in the mashreq may be considered a Janus event. But it also epitomizes a rationale of imperial power that reflects the banality not only of “evil” (an unjust form of governance with insidious forms of exploitation and violence) but also of “good” (caring for the poor and sick and advancing medical and scientific knowledge). Based on archival documents that span a century, the paper reconstructs how psychiatry emerged as a discipline and how it was sustained by the continuous competition between various actors. One the one side stand the Swiss Quaker missionary who founded one of the first modern psychiatric hospitals in the region (founded in 1896) as well as the American Presbyterian missionaries, the British ambassador, native converts, and an eclectic group of notables from across sects who helped establish the hospital and sustain it over time. On the other side stand the native Franciscan priest who established a competing institution for the care of the mentally ill (1920s) as well as his own supporters (including the French authorities) for whom the former’s project was an attempt by the Protestants (and “Anglo-Saxons” broadly speaking) to expand their influence over a scientific territory of tremendous political, social, and increasingly economic leverage.

In 1860, Dr. Nicolas Perron published a translation of a treatise on prophetic medicine attributed to al-Suy???. Perron worked at the new Cairo medical school (est. 1827) before presiding over the French medical school in Algeria. As an Arabist, Perron was deeply interested in organizing and editing writings by major Islamic authors. In La Médecine du prophète, Perron provided an account of what he believed to be the autochthonous medical practice of the Islamic Near East. In his view, prophetic medicine was both an obstacle facing modern European medicine, and an opportunity to couch public health policies in religious terms that local populations would accept. Yet, “prophetic medicine,” as a genre of medical and pietistic writings in the Islamic Near East, had different local histories and meanings than those presumed and advocated by Perron. This paper will look at how colonial imaginaries about local practice and about the relationship between medicine and religion interacted with and influenced local accounts and historical imaginaries and impacted the politics of medical knowledge and practice. It explores how narratives around local Islamic medical practices developed in writings of European medical practitioners, how they were received by local actors, and how colonial and local actors negotiated the boundaries of modern and traditional practices. Here, “prophetic medicine” serves as a central example of how colonial imaginaries developed narratives about locality and traditionalism that came to influence the politics of medical knowledge and practice. At the same time, this reanimation of “prophetic medicine,” despite departing from local histories and traditions, contributed to ongoing intellectual and professional debates about the local and the foreigner, and about modernization and Westernization. I will argue that colonial narratives about local medical practice (including those concerning prophetic medicine) were rooted in a Eurocentric history of knowledge that focused on narratives of “Golden Age” and “Decline,” and emphasized certain qualities of modern science that were posited as opposite to the religious, local and Oriental. At the same time, and with the growth of European-style education, these colonial narratives came to play a significant role in constructing local debates and viewpoints. Moreover, these views on local versus modern medicine were also key in developing public health narratives and institutions in various parts of the Near East.

Medicine has played an important role in the political events that took Egypt by storm since 2011: from the makeshift “field hospitals” erected around Tahrir Square and in other sites of direct political contestation to the role played by independent groups of doctors in reforming the health system after the uprising of 2011, controlling their syndicate and mobilizing for health rights and social justice. Among the spaces of contestation widened, if not opened, by the uprising between the state, on the one hand, and medical professionals, on the other hand, is the role played by forensic evidence in documenting state violence and police brutality. Drawing on fieldwork among medical professionals over the last five years and on scholarship on the role of forensic medicine in controlling populations and exercising political power, this paper will look at the role played by medical professionals, including forensic doctors and psychiatrists, in situations of political violence, and how they wielded their temporally and spatially privileged access to bodily suffering, to contest official accounts about injuries and deaths. The paper will examine the role of the doctor as a witness, and a documenter of state violence within a contested territory of struggle between medical and state authority. It will rely on the analysis offered by the scholarship on expert witnesses and the weight assigned to expert testimonies both in formal legal settings and in larger social contexts to examine the prominent and often-contested role played by medical authority in the context of social and political turmoil by virtue of that medical authority’s enmeshment in a broader knowledge economy that recognizes the body as the grounds for “evidence.” The paper will thus examine some of the tactics used by doctors in wielding their expertise as they bear witness to violence and to evidence of bodily terror, as well as the counter-tactics deployed by the State to discredit that evidence, including denial, intimidation, minimizing and victim-blaming. The paper is interested in how certain groups of doctors were able to negotiate their own ethico-political agency, despite pressures exerted on them to collude in, deny and/or erase the evidence of state violence. The paper thus demonstrates how the Egyptian state, which has for long attempted to shape medical authority as a marker of its modernity, is at the same time entangled in the paradox that this medical authority can potentially challenge its monopoly over the truth.

This paper considers the social and infrastructural contexts leading to the discovery of a specific inherited condition, deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), in certain populations within Iran and Israel during the 1950s and 60s. G6PD deficiency, which occurs with high frequency among Middle Eastern, South Asian, and Central African populations, causes affected individuals to have severe hemolytic reactions to certain antimalarial medications, infections, or foods, notably fava beans, resulting in the condition’s popular name of “favism.” The prevalence of the condition among populations living in malaria-endemic areas has been a major concern for national and international programs to prevent and treat malaria outbreaks. Accordingly, medical scientists in Israel and Iran, in collaboration with visiting American and British researchers, developed diagnostic tests and conducted field surveys to manage and raise awareness about favism. However, favism quickly took on not only clinical but also anthropological significance, because its frequency often varies dramatically between groups divided by social factors such as religion, language, or tribal affiliation. Using scientific publications, personal correspondence, and oral histories, I argue that medical research on G6PD deficiency created an international scientific discourse that perpetuated local nationalist visions of ethnic identity and history. In Iran, physicians found that the Persian-speaking Shi’ite Muslim majority carried the gene, while Zoroastrians and Armenians lacked it. Drawing on Pahlavi-era nationalist historiographies that cast Zoroastrians as the last living representatives of the “original” gene pool of the ancient Persians prior to the Arab-Muslim conquests, Iranian and American geneticists alike argued that the original inhabitants of Iran lacked any mutation for G6PD deficiency until foreign invaders introduced it. This medical narrative corresponded well to Pahlavi sociocultural attitudes that perceived the Arab-Muslim invasions as marking the beginning of Iran’s civilizational decline. Meanwhile, Israeli scientists, who overwhelmingly belonged to the new state’s Ashkenazi sociopolitical elite, identified G6PD deficiency as an ethnic condition occurring only in “non-Ashkenazi” Jews, i.e. marginalized Jewish immigrants from the Mediterranean and Middle Eastern diaspora. These Ashkenazi researchers disagreed with one another, and with European and American geneticists, over how to reconcile this pattern of biological difference between different Jewish groups with a Zionist model of history in which all Jews shared an original gene pool in ancient Judaea. Ultimately, the production and circulation of knowledge about G6PD deficiency illuminate the complex power dynamics between a Western-dominated global biomedical community, Middle Eastern scientists, and disenfranchised research subjects.